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General NPI Number Information
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NPI Number | 1508053133
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Entity Type | Individual
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Provider Name | LINDA GERARD DERBYSHIRE IBCLC
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Gender | Female
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 04/01/2013
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Provider Practice Location Address
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Address Line | 1740 SOUTH ST. SUITE #301
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City | PHILADELPHIA
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State | PA
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Zip | 19146
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Country | US
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Telephone | 610-316-9157
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Fax | 215-735-5690
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Provider Business Mailing Address
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Address Line | 1740 SOUTH ST.
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City | PHILADELPHIA
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State | PA
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Zip | 19146
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Country | US
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Telephone | 610-316-9157
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Fax | 215-735-5690
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 100-16351
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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